title: Clinical activity of lenalidomide in visceral human immunodeficiency virus-related Kaposi sarcoma.
abstract: OBJECTIVE
  Curative treatment of aggressive Kaposi sarcoma (KS) with conventional chemotherapy in human immunodeficiency virus (HIV)-infected patients remains difficult. The administration of thalidomide, an immunomodulatory drug with antiangiogenic effects, is limited by its toxicity. This engenders interest in evaluating thalidomide analogues such as lenalidomide with better toxicity profiles. To our knowledge, we describe for the first time a patient with visceral KS successfully treated with lenalidomide.
  
  
  METHODS
  A man with advanced visceral HIV-related KS progressing after 11 months of highly active antiretroviral therapy (HAART) and 2 lines of conventional chemotherapy (pegylated liposomal doxorubicin and docetaxel) was treated with lenalidomide on a compassionate use basis. He showed a rapid partial response without any substantial adverse effect but experienced relapse after 5 months of treatment, in a context of virologic failure.
  
  
  CONCLUSIONS
  Similar to our observation, good partial response without toxic effects has been reported in 3 patients with only skin involvement. Because immune reconstitution syndrome may occur in HIV-infected patients with KS undergoing HAART, KS improvement may be partly explained by immune recovery. An ongoing US phase 1/2 trial will better evaluate the efficacy and tolerance of lenalidomide in patients with HIV-related KS with and without visceral involvement.
authors.affiliation: Service de Dermatologie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France2Université Paris Diderot Sorbonne Paris Cité, Paris, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Steff
authors.forename: Véronique
authors.initials: V
authors.lastname: Joly
authors.forename: Julie
authors.initials: J
authors.lastname: Di Lucca
authors.forename: Judith
authors.initials: J
authors.lastname: Feldman
authors.forename: Samuel
authors.initials: S
authors.lastname: Burg
authors.forename: Laure
authors.initials: L
authors.lastname: Sarda-Mantel
authors.forename: Gilles
authors.initials: G
authors.lastname: Peytavin
authors.forename: Eduardo
authors.initials: E
authors.lastname: Marinho
authors.forename: Béatrice
authors.initials: B
authors.lastname: Crickx
authors.forename: Eric
authors.initials: E
authors.lastname: Raymond
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lariven
authors.forename: Eve
authors.initials: E
authors.lastname: Maubec
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People; D018791:CD4 Lymphocyte Count; D057176:Compassionate Use Trials; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D000077269:Lenalidomide; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D012514:Sarcoma, Kaposi / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D020533:Angiogenesis Inhibitors; D013792:Thalidomide; D000077269:Lenalidomide